Individual
BRIAN CHARLES DEWIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
705 BROADWAY ST, PAINTSVILLE, KY 41240-1513
(606) 788-0015
Mailing address
P.O. BOX 708, PAINTSVILLE, KY 41240
(606) 788-0015
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4591
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85000552
—
KY
Enumeration date
11/09/2006
Last updated
04/05/2012
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